Mortality and Morbidity among Small for Gestational Age Infants in Extremely Low Birth Weight Infants

PURPOSE: This study is to evaluate the effect of intrauterine growth retardation on the mortality and morbidity in extremely low birth weight infants (ELBWI). METHODS: As retrospectively reviewing 266 ELBWI who were admitted to the neonatal intensive care unit of Samsung Medical Center, the effects of intrauterine growth on mortality and morbidity in ELBWI was assessed by comparing appropriate for gestational age (AGA) ELBWI to small for gestational age (SGA) ELBWI. RESULTS: The number of SGA and AGA infants was 65(24%), 201(76%) respectively. The mean gestational age of the SGA infants (28(+6)+/-2(+3) week) was significantly higher than in the AGA infants (26(+2)+/-1(+3) week) (P<0.001). The mean birth weight of the SGA infants (755+/-173 g) was significantly less than in the AGA infants (830+/-118 g) (P< 0.001). The mortality of the SGA infants (29%) was less than in the AGA infants (33%). However, when adjusted for gestational age, there was no statistically significant difference. The incidence of respiratory distress syndrome of the SGA infants (66%) was significantly lower than in the AGA infants (87%). The incidence of bronchopulmonary dysplasia of the SGA infants (20%) was lower than in the AGA infants (23%). However, when adjusted for gestational age, there were no statistically significant differences. There was no statistically significant association of SGA with intraventricular hemorrhage, retinopathy of prematurity and necrotizing enterocolitis. CONCLUSION: There was no statistically significant association of intrauterine growth retardation with mortality and morbidity in ELBWI.

The Comparative Study of Clinical Manifestations in Acute Poststreptococcal Glomerulonephritis with Gross Hematuria or Microscopic Hematuria

PURPOSE: This study aimed to compare the clinical outcome of acute poststreptocaccal glomerulonephritis (APSGN) between patients who had presented with gross hematuria and those with microscopic hematuria. METHODS: Thirty-nine patients with acute poststreptococcal glomerulonephritis, who were diagnosed from January 2000 to April 2003 were enrolled. RESULTS: The mean age was 8.85 years and the male to female ratio was 1.1:1. Seventeen patients presented with gross hematuria at diagnosis(group A) and twenty-two patients had microscopic hematuria only(group B). There were no significant differences between the two groups in the incidence of edema, fever or history of respiratory infection and oliguria. But hypertension was more frequent in group B. Laboratory data showed decreased C3 and C4 level in group B. Spot urine protein/creatinine ratio and 24hr urine protein showed higher levels in group A. CONCLUSION: Patients with gross hematuria at diagnosis had lower incidence of hypertension and a higher rate of nephrotic range of proteinuria than patients with microscopic hematuria. However, no difference in the duration of admission or complication rate was observed. All patients had clinical improvement during follow-up. We conclude that gross hematuria is not a significant prognostic factor for poststreptococcal glomerulonephritis.